title: Identifying health literacy and health system navigation needs among rural cancer patients: findings from the Rural Oncology Literacy Enhancement Study (ROLES).
abstract: Rural residence is associated with disparities in cancer-related outcomes. Guided by the Chronic Care Model (CCM), the Rural Oncology Literacy Enhancement Study (ROLES) assessed health literacy and patient navigation needs among rural cancer patients. A mixed methods (qualitative and quantitative) approach was used, including: in-depth interviews, health literacy assessments, and phone surveys with cancer patients (N = 53) from 5 oncology clinics in rural Wisconsin; focus groups and self-administered surveys with staff (N = 41) in these clinics. Within four dimensions of the CCM (community resources, self-management support, delivery system design, and decision support), this study uncovered multiple unmet navigation needs, health literacy limitations, and barriers to quality cancer care. System-level implementation of patient navigation and health literacy best practices could contribute to improved cancer care and patient outcomes among rural populations. Further research identifying effective interventions that reduce cancer disparities among rural cancer patients is necessary.
authors.affiliation: Carbone Cancer Center, University of Wisconsin, Madison, WI 53726, USA. martinezdona@wisc.edu
authors.forename: Ana P
authors.initials: AP
authors.lastname: Martinez-Donate
authors.forename: Julie
authors.initials: J
authors.lastname: Halverson
authors.forename: Norma-Jean
authors.initials: NJ
authors.lastname: Simon
authors.forename: Jeanne Schaaf
authors.initials: JS
authors.lastname: Strickland
authors.forename: Amy
authors.initials: A
authors.lastname: Trentham-Dietz
authors.forename: Paul D
authors.initials: PD
authors.lastname: Smith
authors.forename: Rebecca
authors.initials: R
authors.lastname: Linskens
authors.forename: Xinyi
authors.initials: X
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000517:prevention & control*; D062526:Patient Navigation; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012424:Rural Population / Q000706:statistics & numerical data